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Influence of skin cancer on quality of life appears more substantial for women

Women seem to experience more health-related quality of life issues than men for up to 10 years following a diagnosis of the skin cancer melanoma, according to a report in the February issue of Archives of Dermatology, one of the JAMA/Archives journals.

"Although the prognosis is relatively good for about 80 percent of patients with melanoma, they remain at risk for disease progression and have an increased risk of developing subsequent melanomas," according to background information in the article from the authors. Previous studies have suggested about one-third of patients with melanoma have reported significant levels of distress. "Therefore, melanoma can be considered a chronic life-threatening disease that may affect patients' lives considerably."

To assess the impact of melanoma on the health-related quality of life of patients for up to 10 years after diagnosis, Cynthia Holterhues, M.D., from Erasmus MC, Rotterdam, the Netherlands, and colleagues, analyzed responses from a Dutch population-based postal survey among patients with melanoma for 1998 to 2008 using the Eindhoven Cancer Registry. Study participants were sent an impact of cancer survey to measure the well-being of long-term cancer survivors. The 41-item survey included questions on physical, psychological, social, existential, meaning of cancer and health worry.

The response rate to the survey was 80 percent (562 participants). The average age of the respondents was about 57 years, 62 percent were female and 76 percent had a melanoma with a thickness of less than 2 millimeters. "Women were significantly more likely to report higher levels of both positive and negative impacts of cancer," the authors write. The lowest scores were on questions about cancer or treatment-related symptoms of the cancer that interferes with a patients' socializing, traveling, or time with family. The highest score was seen on existential, positive outlook subscale, which covers increased wisdom and spirituality because of the cancer experience. "Women seemed to adjust their sun behavior more often (54 percent vs. 67 percent) than men and were more worried about the deleterious effects of UV radiation (45 percent vs. 66 percent)." In addition, the authors note that this cancer may also affect other parts of patients' lives. "A small proportion of individuals experienced difficulties in getting health insurance as a result of their melanoma, but up to a third of the patients experienced difficulty getting life insurance, disability insurance and/or a mortgage."

In conclusion, the authors write: "In clinical practice, this observation may imply that women need additional care, including follow-up and possibly counseling to optimally cope with their melanoma. However, men might be less aware of general measures of sun protection and need education about these measures after treatment."


Contact: Tamar Nijsten, M.D., Ph.D.
JAMA and Archives Journals

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